STD Awareness: HPV and Smoking

Thursday, November 21, is the Great American Smokeout, a day to abstain from smoking — and, one hopes, to quit for good. “That’s great,” you say, “but what do cigarettes have to do with sexually transmitted diseases?”

Good question!

First, let’s talk about HPV. Human papillomavirus (HPV) is known as the “common cold of STDs” — because pretty much every sexually active person will contract it, even people with very few sex partners. Aside from complete abstinence, the best way to avoid an HPV infection is to be vaccinated with Gardasil, which protects against four common HPV strains — two that cause genital warts, and two that cause certain cancers, such as cervical cancer and oropharyngeal cancer. You can further reduce risk by using condoms and dental dams during all sexual activities, limiting sexual partners, and choosing partners who have had few or no previous partners — however, these risk-reduction methods don’t guarantee that you’ll remain HPV-free.

Harmful chemicals from cigarettes can end up in your cervical mucus!

If you’re sexually active, you could have contracted HPV without ever knowing about it. Most infections are asymptomatic (meaning that you never develop symptoms) and transient (meaning that they go away on their own after a year or two). When symptoms do appear, they can manifest as genital warts, penile skin lesions, cervical abnormalities, and signs of cancer elsewhere on the body. And, sometimes, an HPV infection can become persistent, meaning that it doesn’t go away. Luckily, there are steps you can take to decrease risk of developing HPV symptoms, and to increase your chances of fighting off an HPV infection. And one of those things is to quit smoking!

Cigarettes Affect More Than Just Your Lungs

Most of us know cigarettes have chemicals that can cause cancer. We mostly think of lung cancer, which makes sense: As we inhale the smoke, these chemicals come into direct and prolonged contact with the tissues in our lungs, increasing risk for cancerous mutations. But smoking cigarettes affects more than just your lungs — it can affect your entire airway, and, unfortunately, other parts of your body, including areas below the belt.

One type of cancer that HPV can cause is oropharyngeal cancer — which affects the mouth or throat. In these cases, HPV usually has been spread by unprotected oral sex — and its development into cancer can be exacerbated by smoking. If your mouth has had contact with anyone else’s genitals over the years — especially if there wasn’t a piece of latex between your mouth and those genitals — you could be at risk for oropharyngeal cancer.

How does smoking harm parts of your body beyond your mouth, throat, and lungs? Surprisingly, cigarette products, such as nicotine, can wend their way into cervical mucus, suggesting a possible mechanism by which smoking can affect the development of the types of cervical abnormalities that are detected by Pap testing. A study found that a cancer-causing chemical found in cigarette smoke, benzo[a]pyrene (BaP), can be found in cervical mucus, where it can interact with HPV. While this study only examined cervical cells in a Petri dish — not in humans — the authors postulate that BaP aids in viral replication, possibly hastening the development of cancer.

For decades now, researchers have noted an association between smoking and cervical cancer. For example, a large study published last year followed thousands of women for 13 years and found that smoking did indeed increase cervical cancer risk, especially in women who had been smokers for at least a decade or who smoked 20 or more cigarettes a day.

What about other types of cancer? Smoking can increase risk for cancers beyond those of the lung, throat, mouth, or cervix — it is thought to increase risk for anal cancer and penile cancer, both of which can be caused by HPV. It also raises risk for developing genital warts: Smokers’ immune systems are less likely to be able to fight off a genital wart infection, and in the case of a persistent infection, smokers’ warts are more likely to return even after being removed by a health care provider.

So, whether you’ve never touched a cigarette in your life, or are a former smoker, the decision not to smoke reduces risk for genital warts and a variety of HPV-associated cancers.

Smoking Interferes with Immunity

Your immune system is a wondrous work of evolution, which has developed over time to keep you safe from microbes, cancer cells, and other dangers. Unfortunately, smoking interferes with your immune system’s ability to do its job.

The tar and other chemicals in cigarettes make it difficult for your immune system to fight off other infections — including an HPV infection that might be able to cause warts or cancer. And, if you’re unlucky enough to develop cancer, your immune system is less equipped to attack it.

What’s the Point of Quitting?

Maybe you’ve been smoking for decades by now; you might wonder if there’s even a point to quitting or if the damage has already been done. Fortunately, it’s always a good time to quit, and you’ll start reaping the benefits immediately. For example, in just 12 hours, the carbon monoxide level in your lungs returns to normal, and within months the cilia in your lungs regain their functionality. In just a year, your increased risk of coronary heart disease is cut in half.

And, five years after quitting, your risk of oropharyngeal cancer falls by half, and your risk of cervical cancer returns to that of a nonsmoker. So, no, it’s never too late to quit!

Arizonans looking for help quitting smoking can seek out Planned Parenthood’s smoking-cessation programs or the University of Arizona’s ASHLine. Nationwide, the National Cancer Institute has a list of other resources that can help you begin the process of quitting. Although the Great American Smokeout serves as an opportunity for individuals to kick the habit, or for groups to quit together, any day is a good day to quit smoking.

Click here to check out other installments of our monthly STD Awareness series!

About Anna C.

Anna first volunteered for Planned Parenthood as a high school student in the 1990s. Since then, she has received a bachelor’s degree from UC Berkeley and a master's degree in epidemiology from the University of Arizona. As an ode to her fascination with microbes, she writes the monthly STD Awareness series, as well as other pieces focusing on health and medicine.

6 thoughts on “STD Awareness: HPV and Smoking”

I have been trying to find out on the internet as to how much can collect in your cervical mucus if you only smoke 14 cigarettes/per week, meaning as to how dramatically it can affect your cervix and if you are not having sex? How long can it for nicotine/ byproducts to leave all cells/ mucus in your body? THANK YOU IMMENSELY FOR YOUR RESPONSE!!!! Sincerely, Suzee

Of course one of the best things a smoker can do for their health is to quit smoking. Failing that, reducing consumption of cigarettes is a great first step.

I’m not sure if the answers to your questions are out there — there is still a lot of research to do on the effect of smoking on the cervical mucus. But, if you are inclined to wade through the scientific literature, here are some places to start:

That’s a lot of material to look through, and it might not even contain the answers to your questions, but perhaps someday soon I’ll take a look at it myself and write in more depth about the interaction between smoking and cervical mucus. Sorry I couldn’t be of more help, but that’s too much material for me to read at this time!

I was with only one man. The same man for 5 years and he was unfaithful. I found out after a cluster in my anal region that I had contracted genital warts. And that they were not hemrhoids I smoked about 3 packs a week and had a bad diet. I have started being extra clean down there cleaning with wet wipes after I go number two. I’m 8 days clean from ciggs and switched to vaping instead and have changed my diet. But the break outs are still painful and I don’t know what to do. My heart is breaking and I feel as if I can never be sexually active again because of it. What can I do to increase my chances of this outbreak going away. I know there isn’t a cure but there must be a way to reduce outbreaks without extreme treatment!

For most people, genital/anal warts will go away on their own, and you can increase your body’s chances of clearing the virus out of your system by living a healthy lifestyle — a healthful diet, exercise, avoiding stress, getting enough sleep, and quitting smoking. That might include quitting vaping; there are no long-term studies on vaping, and I can’t find any studies on the effect vaping might have on warts or even the immune system as a whole.

There are also treatments you can receive from a doctor, which can include freezing them (cryotherapy), burning them off (electrocauterization), removing them with lasers, or injecting them with an antiviral medication called interferon. They can also prescribe a topical medication you can apply yourself at home. Since there are so many options, you might try to talk to a health-care provider just to see if any are acceptable to you. Of course, removing the warts doesn’t cure the virus, so they might come back, but chances are that within a couple of years, your immune system will have successfully beaten the virus on its own. Positive lifestyle changes can increase your odds!

My partner and I have oral sex and he e-cigs, and I think that is affecting me down there. I know it’s electronic but it must have some kind of nicotine in it. I never have had yeast infection before and recently I did I thought was something else but now reading this I think was because of his e-cig smoking.